Pathophysiology of multiple sclerosis damage and repair: Linking cerebral hypoperfusion to the development of irreversible tissue loss in multiple sclerosis using magnetic resonance imaging

Mascali, Daniele, Villani, Alessandro, Chiarelli, Antonio M., Biondetti, Emma, Lipp, Ilona, Digiovanni, Anna, Pozzilli, Valeria, Caporale, Alessandra S., Rispoli, Marianna G., Ajdinaj, Paola, D'Apolito, Maria, Grasso, Eleonora, Sensi, Stefano L., Murphy, Kevin ORCID: https://orcid.org/0000-0002-6516-313X, Tomassini, Valentina ORCID: https://orcid.org/0000-0002-7368-6280 and Wise, Richard G. ORCID: https://orcid.org/0000-0003-1700-2144 2023. Pathophysiology of multiple sclerosis damage and repair: Linking cerebral hypoperfusion to the development of irreversible tissue loss in multiple sclerosis using magnetic resonance imaging. European Journal of Neurology 30 (8) , pp. 2348-2356. 10.1111/ene.15827

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Abstract

Background and purpose: Reduced cerebral perfusion has been observed in multiple sclerosis (MS) and may contribute to tissue loss both acutely and chronically. Here, we test the hypothesis that hypoperfusion occurs in MS and relates to the presence of irreversible tissue damage. Methods: In 91 patients with relapsing MS and 26 healthy controls (HC), gray matter (GM) cerebral blood flow (CBF) was assessed using pulsed arterial spin labeling. GM volume, T1 hypointense and T2 hyperintense lesion volumes (T1LV and T2LV, respectively), and the proportion of T2‐hyperintense lesion volume that appears hypointense on T1‐weighted magnetic resonance imaging (T1LV/T2LV) were quantified. GM CBF and GM volume were evaluated globally, as well as regionally, using an atlas‐based approach. Results: Global GM CBF was lower in patients (56.9 ± 12.3 mL/100 g/min) than in HC (67.7 ± 10.0 mL/100 g/min; p < 0.001), a difference that was widespread across brain regions. Although total GM volume was comparable between groups, significant reductions were observed in a subset of subcortical structures. GM CBF negatively correlated with T1LV (r = −0.43, p = 0.0002) and T1LV/T2LV (r = −0.37, p = 0.0004), but not with T2LV. Conclusions: GM hypoperfusion occurs in MS and is associated with irreversible white matter damage, thus suggesting that cerebral hypoperfusion may actively contribute and possibly precede neurodegeneration by hampering tissue repair abilities in MS.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Psychology Physics and Astronomy Cardiff University Brain Research Imaging Centre (CUBRIC)
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/
Publisher:	Wiley
ISSN:	1351-5101
Date of First Compliant Deposit:	31 May 2023
Date of Acceptance:	1 May 2023
Last Modified:	24 Aug 2023 22:58
URI:	https://orca.cardiff.ac.uk/id/eprint/160067

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